Human immunodeficiency virus patients with low CD4 counts are more likely to have precancerous polyps identified during index colonoscopy  

作　　者：Michelle Likhtshteyn Evan Marzouk Fray M Arroyo-Mercado Gurasees Chawla Sabrina Rosengarten Renata Lerer Hector Ojeda-Martinez Savanna Thor 

机构地区：[1]Department of Gastroenterology,SUNY Downstate Health Sciences University,Brooklyn,NY 11203,United States [2]Department of Internal Medicine and Pediatrics,Baystate Medical Center,Springfield,IL 01199,United States [3]Department of Gastroenterology,University of New Mexico,Albuquerque,NM 87106,United States [4]Department of Emergency Medicine,New York-Presbyterian Queens Hospital,Queens,NY 11355,United States [5]Department of Gastroenterology,University of Pennsylvania,Philadelphia,PA 19104,United States [6]Department of Infectious Disease,Nuvance Health-Vassar Brothers Medical Center,Poughkeepsie,NY 12601,United States

出　　处：《World Journal of Gastrointestinal Endoscopy》2023年第9期545-552,共8页世界胃肠内镜杂志（英文版）（电子版）

基　　金：The project,“Adenoma prevalence,characteristics,and outcomes on screening colonoscopy in patients with HIV in an Urban Safety Net Hospital and Urban University Hospital”was approved by SUNY Downstate Health Sciences IRB on October 13,2020,No.1306045.

摘　　要：BACKGROUND Antiretroviral treatment(ART)has improved the life expectancy of patients living with human immunodeficiency virus(HIV).As these patients age,they are at increased risk for developing non-acquired immunodeficiency syndrome defining malignancies(NADMs)such as colon cancers.AIM To determine which factors are associated with the development of precancerous polyps on screening colonoscopy in patients with HIV and to investigate whether HIV disease status,measured by viral load and CD4 count,might influence precancerous polyp development.METHODS A retrospective review of records at two urban academic medical centers was performed for HIV patients who had a screening colonoscopy between 2005-2015.Patients with a history of colorectal cancer or polyps,poor bowel preparation,or inflammatory bowel disease were excluded.Demographic data such as sex,age,race,and body mass index(BMI)as well as information regarding the HIV disease status such as CD4 count,viral load,and medication regimen were collected.Well-controlled patients were defined as those that had viral load<50 copies,and poorly-controlled patients were those with viral load≥50.Patients were also stratified based on their CD4 count,comparing those with a low CD4 count to those with a high CD4 count.Using colonoscopy reports in the medical record,the size,histology,and number of polyps were recorded for each patient.Precancerous polyps included adenomas and proximal serrated polyps.Data was analyzed using Fisher’s exact tests and logistic regression through SAS 3.8 software.RESULTS Two hundred and seven patients met our inclusion criteria.The mean age was 56.13 years,and 58%were males.There were no significant differences in terms of age,race or ethnicity,insurance,and smoking status between patients with CD4 counts above or below 500.BMI was lower in patients with CD4 count<500 as compared to those with count>500(P=0.0276).In patients with CD4>500,53.85%of patients were female,and 70.87%of patients with CD4<500 were male(P=0.0004).Only 1.92%of patie

关 键 词：COLONOSCOPY Non-acquired immunodeficiency syndromes defining malignancies Human immunodeficiency virus Adenoma detection rate Antiretroviral treatment Advanced adenoma 

分 类 号：R735.34[医药卫生—肿瘤]